Dataset Information

Revision of the Cognitive Assessment for Dementia, iPad version (CADi2).

ABSTRACT: Early detection of dementia is crucial because it is the time when intervention is most effective. Therefore, a simple and short test is necessary for primary mass screening in community-based medical facilities. We developed the Cognitive Assessment for Dementia, iPad version (CADi) which consists of 10 simple questions and is self-administered. In this paper we present a revised version which improves the detection of dementia. Two questions of the CADi were replaced in the latest version (CADi2). We examined the validity and reliability of the CADi2 in 27 Alzheimer's disease patients and age-matched healthy controls. The Alzheimer's disease patients had lower CADi2 scores and longer total response times to questions compared to the controls. The CADi2 had high sensitivity (0.85-0.96) and specificity (0.81-0.93), and showed significant correlations with existing standard neuropsychological tests. Cronbach's alpha analysis revealed moderate consistency of the CADi2. These results support the utility of the CADi2 for primary screening for dementia.

SUBMITTER: Onoda K

PROVIDER: S-EPMC4195614 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Revision of the Cognitive Assessment for Dementia, iPad version (CADi2).

Onoda Keiichi K Yamaguchi Shuhei S

PloS one 20141013 10

Early detection of dementia is crucial because it is the time when intervention is most effective. Therefore, a simple and short test is necessary for primary mass screening in community-based medical facilities. We developed the Cognitive Assessment for Dementia, iPad version (CADi) which consists of 10 simple questions and is self-administered. In this paper we present a revised version which improves the detection of dementia. Two questions of the CADi were replaced in the latest version (CAD ...[more]

PMID: 25310860

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Project description:OBJECTIVES:While various short variants of the Montreal Cognitive Assessment (MoCA) have been developed, they have not been compared among each other to determine the most optimal variant for routine use. This study evaluated the comparative performance of the short variants in identifying mild cognitive impairment or dementia (MCI/dementia). DESIGN:Baseline data of a cohort study. SETTING:Alzheimer's Disease Centers across the United States. PARTICIPANTS:Participants aged ≥50 years (n = 4606), with median age 70 (interquartile range 65-76). MEASURES:Participants completed MoCA and were evaluated for MCI/dementia. The various short variants of MoCA were compared in their performance in discriminating MCI/dementia, using areas under the receiver operating characteristic curve (AUCs). RESULTS:All 7 short variants of MoCA had acceptable performance in discriminating MCI/dementia from normal cognition (AUC 87.7%-91.0%). However, only 2 variants by Roalf et al (2016) and Wong et al (2015) demonstrated comparable performance (AUC 88.4-88.9%) to the original MoCA (AUC 89.3%). Among the participants with higher education, only the variant by Roalf et al had similar AUC to the original MoCA. At the optimal cut-off score of <25, the original MoCA demonstrated 84.4% sensitivity and 76.4% specificity. In contrast, the short variant by Roalf et al had 87.2% sensitivity and 72.1% specificity at its optimal cut-off score of <13. CONCLUSIONS/IMPLICATIONS:The various short variants may not share similar diagnostic performance, with many limited by ceiling effects among participants with higher education. Only the short variant by Roalf et al was comparable to the original MoCA in identifying MCI or dementia even across education subgroups. This variant is one-third the length of the original MoCA and can be completed in <5 minutes. It provides a viable alternative when it is not feasible to administer the original MoCA in clinical practice and can be especially useful in nonspecialty clinics with large volumes of patients at high risk of cognitive impairment (such as those in primary care, geriatric, and stroke prevention clinics).

Project description:Healthcare and human services are increasingly required to demonstrate effectiveness and efficiency of their programs, with assessment and evaluation processes more regularly part of activity cycles. New approaches to service delivery, such as the National Disability Insurance Scheme (NDIS) scheme in Australia, require outcome-focused reporting that is responsive to the perspectives of clients. Eco-systematic approaches to service delivery and assessment consider the client as part of an interconnected web of stakeholders who all have responsibility for and contribute to their development and progress. These imperatives provide challenges for modalities for which there are not well-established assessment approaches. Dance movement therapists face particular difficulties in this respect, as they have few assessment tools that are practical for regular use. Existing dance movement therapy (DMT) assessment approaches largely do not yet prioritize input from clients. This article addresses these challenges in reporting a trial of iPad app MARA (Movement Assessment and Reporting App) developed for assessment in DMT. MARA is applied in a program for adults with intellectual disability (ID) over 16 weeks. Assessment data is gathered utilizing the app's features: two researcher-therapists undertake quantitative scoring that MARA aggregates into graphs, substantiated by qualitative note-taking, photos, and videos; and clients provide feedback about their progress stimulated by viewing photos and videos. A sample graph generated by MARA and supporting notes and a report drawn from data are provided. Responses to reports from program stakeholders (12 participants, 12 families, 11 center staff) gathered through interviews and focus groups are discussed, and researcher-therapists' reflections are detailed. The benefits of using MARA reported by researcher-therapists include strengthened capacity to focus on participant outcomes, assess efficiently, plan and make decisions for the program, and communicate participants' progress to stakeholders. Family members perceive reports drawn from data gathered in MARA to be useful in enabling better understanding of the DMT program and participant outcomes and potentially to support NDIS service planning. Managers perceive the potential value of data in these reports for quality control and resource decisions, while other staff confirm the therapists' perspective that reports offer the possibility of improved communication and collaboration between center staff.

Dataset Information

Revision of the Cognitive Assessment for Dementia, iPad version (CADi2).

Publications

Revision of the Cognitive Assessment for Dementia, iPad version (CADi2).

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